Spontaneous regression of a cystic hypoglossal schwannoma causing unilateral tongue atrophy

Abstract

A 60-year-old lady presented with intermittent headaches. Examination revealed striking marked unilateral tongue atrophy. Magnetic resonance imaging (MRI) revealed a cystic lesion in the hypoglossal canal and a provisional diagnosis of cystic hypoglossal schwannoma made. Annual surveillance scans showed stable appearances but surprisingly at 3 years they showed a significant reduction in the size of the lesion. Most patients with hypoglossal schwannomas present with ipsilateral hypoglossal nerve palsy; careful cranial nerve examination is vital in diagnosing such rare lesions. Little is known of their natural history, with most lesions undergoing surgery. This case highlights spontaneous regression following non-operative management.

Keywords::

• hypoglossal nerve
• schwannoma
• tongue atrophy

Declaration of interest: The authors report no declarations of interest. The authors alone are responsible for the content and writing of the paper.